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ABSTRACT
This thesis aims to understand the current perspectives on the subject
tobaccoism and psychiatric comorbidades, to investigate the evaluation of the
effectiveness of the treatment of the nicotine dependence and variable related with the
ceasing process to smoke, as well as verifying the index of fallen again between the
individuals that search the recovery. In the first study a not systematic revision of
literature was carried through. The upheavals of mood, upheavals of anxiety,
schizophrenia had been studied, other upheavals for psychoactive substance use beyond
other psychiatric upheavals that had been also identified in literature as related to the
tobaccoism. It is argued hypothesis of the use of the nicotine as self-medication in the
mental upheavals. Possible contributions of the knowledge for the clinical interventions
in the treatment of the tobaccoism are presented. In as the study a random longitudinal
clinical assay was carried through carried through to evaluate the treatment
effectiveness, the sample was chosen by convenience formed for dependent patients of
nicotine who had looked clinic treatment in a general hospital. The instruments used for
dependence of the nicotine were the Fagerström Test will be Nicotine Dependence
(FTND), for the motivation for change were used the University scale of Rhode Island
Change Assessment Scale (URICA), for the psychiatric comorbidades Escale
International Neuropsychiatric Interview (MINI), and finally, were used a standardized
questionnaire, half-structuralized for evaluation of demographic data, history of
tobaccoism, social support, attempts to stop, main organic problems attributed to the
tobaccoism. Two forms of treatment for the tobaccoism had been evaluated. A
treatment of intensive minimum intervention (group has controlled) and a program of
treatment of group psycotherapy (experimental group). The two modalities of treatment
had been compared and associates with the variable, history, motivation for change,
degree of addition, demographic psychiatric and characteristic comorbities. 181
patients had been enclosed in the study, 93 in the group intervention and 88 in the
group have controlled. The majority (63%) was of the feminine sex and 57% had
between 31 and 50 years of age, without differences between the groups. 56% were
married or lived with friend- 14% lived alone. Significant difference was observed
(p=0, 002) enters the groups for the changeable school level. One observed that almost
60% had started to smoke until the 15 years and 66% had started to smoke regularly
until the 18 years, approximately three rooms of the citizens they smoked 20 or more
cigarettes per day and had looked treatment without indication. The group intervention
presented more upheavals in comorbities (53%) of what the group has controlled
(36%), predominating the upheavals of mood in both groups - 38% versus 25%,
respectively. The levels of dependence of the nicotine thus had been distributed: it has
led: 35%; moderate: high 42% and: 23%. How much to the motivation for change, 13%
of the sample were in the period of training of daily pay-contemplation, 33% in the
period of training of contemplation, 50% in the period of training of action and 3%. As
conclusion of these data we can observe that the reason of prevalences was of 2,33, that
is, 80% of the patients of the group intervention were abstinentes against 34% of the
group has controlled, what it allows esteem an effectiveness at this moment of 57%. To
the 90 days, this reason went up for 3,22, implying in an effectiveness of the treatment
of 69%; to the end of the study, 180 days after the beginning, this reason went up for
4,72, being able itself to attribute to the carried through treatment a 79% effectiveness.
The purpose of the third study was to investigate factors associates to the fallen again
one, as the social demographic characteristics, the motivational periods of training and
the degree of dependence to the nicotine. The citizens had been enclosed for